The best laid plans of mice and men…

Entries Tagged as 'Health Care'

This is from an article by Sara Robinson published on Campaign for America’s Future.

1. Canada’s health care system is “socialized medicine.”
False. In socialized medical systems, the doctors work directly for the state. In Canada (and many other countries with universal care), doctors run their own private practices, just like they do in the US. The only difference is that every doctor deals with one insurer, instead of 150. And that insurer is the provincial government, which is accountable to the legislature and the voters if the quality of coverage is allowed to slide.

The proper term for this is “single-payer insurance.” In talking to Americans about it, the better phrase is “Medicare for all.”

2. Doctors are hurt financially by single-payer health care.
True and False. Doctors in Canada do make less than their US counterparts. But they also have lower overhead, and usually much better working conditions. A few reasons for this:

First, as noted, they don’t have to charge higher fees to cover the salary of a full-time staffer to deal with over a hundred different insurers, all of whom are bent on denying care whenever possible. In fact, most Canadian doctors get by quite nicely with just one assistant, who cheerfully handles the phones, mail, scheduling, patient reception, stocking, filing, and billing all by herself in the course of a standard workday.

Second, they don’t have to spend several hours every day on the phone cajoling insurance company bean counters into doing the right thing by their patients. My doctor in California worked a 70-hour week: 35 hours seeing patients, and another 35 hours on the phone arguing with insurance companies. My Canadian doctor, on the other hand, works a 35-hour week, period. She files her invoices online, and the vast majority are simply paid — quietly, quickly, and without hassle. There is no runaround. There are no fights. Appointments aren’t interrupted by vexing phone calls. Care is seldom denied (because everybody knows the rules). She gets her checks on time, sees her patients on schedule, takes Thursdays off, and gets home in time for dinner.

One unsurprising side effect of all this is that the doctors I see here are, to a person, more focused, more relaxed, more generous with their time, more up-to-date in their specialties, and overall much less distracted from the real work of doctoring. You don’t realize how much stress the American doctor-insurer fights put on the day-to-day quality of care until you see doctors who don’t operate under that stress, because they never have to fight those battles at all. Amazingly: they seem to enjoy their jobs.

Third: The average American medical student graduates $140,000 in hock. The average Canadian doctor’s debt is roughly half that.

Finally, Canadian doctors pay lower malpractice insurance fees. When paying for health care constitutes a one of a family’s major expenses, expectations tend to run very high. A doctor’s mistake not only damages the body; it may very well throw a middle-class family permanently into the ranks of the working poor, and render the victim uninsurable for life. With so much at stake, it’s no wonder people are quick to rush to court for redress.

Canadians are far less likely to sue in the first place, since they’re not having to absorb devastating financial losses in addition to any physical losses when something goes awry. The cost of the damaging treatment will be covered. So will the cost of fixing it. And, no matter what happens, the victim will remain insured for life. When lawsuits do occur, the awards don’t have to include coverage for future medical costs, which reduces the insurance company’s liability.

3. Wait times in Canada are horrendous.
True and False again — it depends on which province you live in, and what’s wrong with you. Canada’s health care system runs on federal guidelines that ensure uniform standards of care, but each territory and province administers its own program. Some provinces don’t plan their facilities well enough; in those, you can have waits. Some do better. As a general rule, the farther north you live, the harder it is to get to care, simply because the doctors and hospitals are concentrated in the south. But that’s just as true in any rural county in the U.S.

You can hear the bitching about it no matter where you live, though. The percentage of Canadians who’d consider giving up their beloved system consistently languishes in the single digits. A few years ago, a TV show asked Canadians to name the Greatest Canadian in history; and in a broad national consensus, they gave the honor to Tommy Douglas, the Saskatchewan premier who is considered the father of the country’s health care system. (And no, it had nothing to do with the fact that he was also Kiefer Sutherland’s grandfather.). In spite of that, though, grousing about health care is still unofficially Canada’s third national sport after curling and hockey.

And for the country’s newspapers, it’s a prime watchdogging opportunity. Any little thing goes sideways at the local hospital, and it’s on the front pages the next day. Those kinds of stories sell papers, because everyone is invested in that system and has a personal stake in how well it functions. The American system might benefit from this kind of constant scrutiny, because it’s certainly one of the things that keeps the quality high. But it also makes people think it’s far worse than it is.

Critics should be reminded that the American system is not exactly instant-on, either. When I lived in California, I had excellent insurance, and got my care through one of the best university-based systems in the nation. Yet I routinely had to wait anywhere from six to twelve weeks to get in to see a specialist. Non-emergency surgical waits could be anywhere from four weeks to four months. After two years in the BC system, I’m finding the experience to be pretty much comparable, and often better. The notable exception is MRIs, which were easy in California, but can take many months to get here. (It’s the number one thing people go over the border for.) Other than that, urban Canadians get care about as fast as urban Americans do.

4. You have to wait forever to get a family doctor.
False for the vast majority of Canadians, but True for a few. Again, it all depends on where you live. I live in suburban Vancouver, and there are any number of first-rate GPs in my neighborhood who are taking new patients. If you don’t have a working relationship with one, but need to see a doctor now, there are 24-hour urgent care clinics in most neighborhoods that will usually get you in and out on the minor stuff in under an hour.

It is, absolutely, harder to get to a doctor if you live out in a small town, or up in the territories. But that’s just as true in the U.S. — and in America, the government won’t cover the airfare for rural folk to come down to the city for needed treatment, which all the provincial plans do.

5. You don’t get to choose your own doctor.
Scurrilously False. Somebody, somewhere, is getting paid a lot of money to make this kind of stuff up. The cons love to scare the kids with stories about the government picking your doctor for you, and you don’t get a choice. Be afraid! Be very afraid!

For the record: Canadians pick their own doctors, just like Americans do. And not only that: since it all pays the same, poor Canadians have exactly the same access to the country’s top specialists that rich ones do.

6. Canada’s care plan only covers the basics.
You’re still on your own for any extras, including prescription drugs. And you still have to pay for it.
True — but not as big an issue as you might think. The province does charge a small monthly premium (ours is $108/month for a family of four) for the basic coverage. However, most people never even have to write that check: almost all employers pick up the tab for their employees’ premiums as part of the standard benefits package; and the province covers it for people on public assistance or disability.

“The basics” covered by this plan include 100% of all doctor’s fees, ambulance fares, tests, and everything that happens in a hospital — in other words, the really big-ticket items that routinely drive American families into bankruptcy. In BC, it doesn’t include “extras” like medical equipment, prescriptions, physical therapy or chiropractic care, dental, vision, and so on; and if you want a private or semi-private room with TV and phone, that costs extra (about what you’d pay for a room in a middling hotel). That other stuff does add up; but it’s far easier to afford if you’re not having to cover the big expenses, too. Furthermore: you can deduct any out-of-pocket health expenses you do have to pay off your income taxes. And, as every American knows by now, drugs aren’t nearly as expensive here, either.

Filling the gap between the basics and the extras is the job of the country’s remaining private health insurers. Since they’re off the hook for the ruinously expensive big-ticket items that can put their own profits at risk, the insurance companies make a tidy business out of offering inexpensive policies that cover all those smaller, more predictable expenses. Top-quality add-on policies typically run in the ballpark of $75 per person in a family per month — about $300 for a family of four — if you’re stuck buying an individual plan. Group plans are cheap enough that even small employers can afford to offer them as a routine benefit. An average working Canadian with employer-paid basic care and supplemental insurance gets free coverage equal to the best policies now only offered at a few of America’s largest corporations. And that employer is probably only paying a couple hundred dollars a month to provide that benefit.

7. Canadian drugs are not the same.
More preposterious bogosity. They are exactly the same drugs, made by the same pharmaceutical companies, often in the same factories. The Canadian drug distribution system, however, has much tighter oversight; and pharmacies and pharmacists are more closely regulated. If there is a difference in Canadian drugs at all, they’re actually likely to be safer.

Also: pharmacists here dispense what the doctors tell them to dispense, the first time, without moralizing. I know. It’s amazing.

8. Publicly-funded programs will inevitably lead to rationed health care, particularly for the elderly.
False. And bogglingly so. The papers would have a field day if there was the barest hint that this might be true.

One of the things that constantly amazes me here is how well-cared-for the elderly and disabled you see on the streets here are. No, these people are not being thrown out on the curb. In fact, they live longer, healthier, and more productive lives because they’re getting a constant level of care that ensures small things get treated before they become big problems.

The health care system also makes it easier on their caregiving adult children, who have more time to look in on Mom and take her on outings because they aren’t working 60-hour weeks trying to hold onto a job that gives them insurance.

9. People won’t be responsible for their own health if they’re not being forced to pay for the consequences.
False. The philosophical basis of America’s privatized health care system might best be characterized as medical Calvinism. It’s fascinating to watch well-educated secularists who recoil at the Protestant obsession with personal virtue, prosperity as a cardinal sign of election by God, and total responsibility for one’s own salvation turn into fire-eyed, moralizing True Believers when it comes to the subject of Taking Responsibility For One’s Own Health.

They’ll insist that health, like salvation, is entirely in our own hands. If you just have the character and self-discipline to stick to an abstemious regime of careful diet, clean living, and frequent sweat offerings to the Great Treadmill God, you’ll never get sick. (Like all good theologies, there’s even an unspoken promise of immortality: f you do it really really right, they imply, you might even live forever.) The virtuous Elect can be discerned by their svelte figures and low cholesterol numbers. From here, it’s a short leap to the conviction that those who suffer from chronic conditions are victims of their own weaknesses, and simply getting what they deserve. Part of their punishment is being forced to pay for the expensive, heavily marketed pharmaceuticals needed to alleviate these avoidable illnesses. They can’t complain. It was their own damned fault; and it’s not our responsibility to pay for their sins. In fact, it’s recently been suggested that they be shunned, lest they lead the virtuous into sin.

Of course, this is bad theology whether you’re applying it to the state of one’s soul or one’s arteries. The fact is that bad genes, bad luck, and the ravages of age eventually take their toll on all of us — even the most careful of us. The economics of the Canadian system reflect this very different philosophy: it’s built on the belief that maintaining health is not an individual responsibility, but a collective one. Since none of us controls fate, the least we can do is be there for each other as our numbers come up.

This difference is expressed in a few different ways. First: Canadians tend to think of tending to one’s health as one of your duties as a citizen. You do what’s right because you don’t want to take up space in the system, or put that burden on your fellow taxpayers. Second, “taking care of yourself” has a slightly expanded definition here, which includes a greater emphasis on public health. Canadians are serious about not coming to work if you’re contagious, and seeing a doctor ASAP if you need to. Staying healthy includes not only diet and exercise; but also taking care to keep your germs to yourself, avoiding stress, and getting things treated while they’re still small and cheap to fix.

Third, there’s a somewhat larger awareness that stress leads to big-ticket illnesses — and a somewhat lower cultural tolerance for employers who put people in high-stress situations. Nobody wants to pick up the tab for their greed. And finally, there’s a generally greater acceptance on the part of both the elderly and their families that end-of-life heroics may be drawing resources away from people who might put them to better use. You can have them if you want them; but reasonable and compassionate people should be able to take the larger view.

The bottom line: When it comes to getting people to make healthy choices, appealing to their sense of the common good seems to work at least as well as Calvinist moralizing.

10. This all sounds great — but the taxes to cover it are just unaffordable. And besides, isn’t the system in bad financial shape?
False. On one hand, our annual Canadian tax bite runs about 10% higher than our U.S. taxes did. On the other, we’re not paying out the equivalent of two new car payments every month to keep the family insured here. When you balance out the difference, we’re actually money ahead. When you factor in the greatly increased social stability that follows when everybody’s getting their necessary health care, the impact on our quality of life becomes even more signficant.

And True — but only because this is a universal truth that we need to make our peace with. Yes, the provincial plans are always struggling. So is every single publicly-funded health care system in the world, including the VA and Medicare. There’s always tension between what the users of the system want, and what the taxpayers are willing to pay. The balance of power ebbs and flows between them; but no matter where it lies at any given moment, at least one of the pair is always going to be at least somewhat unhappy.

But, as many of us know all too well, there’s also constant tension between what patients want and what private insurers are willing to pay. At least when it’s in government hands, we can demand some accountability. And my experience in Canada has convinced me that this accountability is what makes all the difference between the two systems.

It is true that Canada’s system is not the same as the U.S. system. It’s designed to deliver a somewhat different product, to a population that has somewhat different expectations. But the end result is that the vast majority of Canadians get the vast majority of what they need the vast majority of the time. It’ll be a good day when when Americans can hold their heads high and proudly make that same declaration.

You can read the complete article and more of what Sara Robinson has to say on OurFuture.org.

She’s saying she lost her health care coverage (because of Obamacare — but she didn’t provide any hard reason) and refuses to use the exchange because it’s glitchy — but here’s the interesting thing: she states in her argument that it’s the DC exchange (that’s not the same thing as HealthCare.gov — the national exchange for states that didn’t want to invest in their own exchange — DC actually operates it’s own exchange).

If you watch the video (linked below), you’ll also notice she’s obviously reading from a teleprompter — her eyes are fixed on something other than the hosts she’s talking to.

The best quote:

I’m not gonna waste an hour on that thing.· Michelle Bachmann

That’s fine with me; she can just pay the IRS fines for not complying with the new law (the law that the Supreme Court has already ruled is constitutional) and continue to be a burden on society (something she appears to be very good at).

While I’ll be one of the first to rant on how botched the roll out of the national health care exchange has been; I’ll also quickly point out that states had the option of coming up with their own exchanges, and the ones that did aren’t having anywhere near the number of issues. I personally didn’t care for the health care reform, my feeling was that we needed to implement a single payer system much more like what Canada has (but that didn’t happen because health care dollars line the pockets of too many senators and representatives).

I’ll be honest, I think Michele Bachmann is crazy (and probably should be in a padded room), but this is just absolutely ridiculous — get over it, and vent on your insurance company, they’re the real villains in all this.

One thing that’s almost an invariant in the world is that if American big business is behind legislation it’s because it serves their own interest and greed — not the public interest.

The only thing American big business cares about the public for is finding new ways to milk money from them and insure that the public pay more than their share of taxes.

With very few exceptions American business (and the ultra-rich American’s that run those businesses) are self-serving, and only looking out for their interests and profits. They are motivated by greed.

So when the pharmaceutical companies, insurance companies, large hospitals, and health care industry get behind a plan that doesn’t seem to improve anything for the American public it should be clear to everyone who they’re looking to improve things for.

The real problem in America is that special interest groups run the country; and almost all politicians who’ve been in office more than two terms (and most presidents) cater to their interests and don’t want to really change the status quo.

Those who are elected to serve the public interest actually serve no interests but their own!

There are a number of comparisons between the Canadian and US health care systems; and like with any complex issue you can make the comparison show almost anything you want depending on the metrics chosen for the comparison and the facts included (or omitted).

Often the Canadian and American systems are compared since until the 1960s they were extremely similar, and Canadian and Americans share a large common history and to some extent culture.

This comparison on Wikipedia appears to be an honest attempt to compare and contrast the two systems, it includes a number of citations. I recommend reading it, and considering what it has to say in light of the the current state health care in the US.

This information is copied from Our Dental Care BLOG (please see the note at the end of this post for additional information, please visit their site to read the entire post — complete with additional reference links):

In their 2016 report, the Alzheimer’s Association found that a staggering 5.4 million Americans are currently suffering from Alzheimer’s disease or related disorders (ADRD). This number is projected to skyrocket to 16 million by 2050, the most pressing epidemic for our aging population.
While it’s alarming that someone develops Alzheimer’s every minute in the United States today, this rate has the potential to double by 2050. The rapidly increasing presence of such a debilitating disease raises serious concerns regarding healthcare costs and the availability of effective treatment options. As a result, we are already seeing inadequacies in dental care for patients with Alzheimer’s.
Poor training and strained communication are among the most prominent reasons dental pain among nursery home residents with Alzheimer’s goes undetected, and therefore untreated.
But the problem is a multi-faceted dilemma, one that will require the awareness and cooperation of patients, caregivers and dental professionals to overcome.
…

I’ve added this post by request to assist in helping individuals locate resources. You should see the Disclaimer and Privacy Policy on the site before making any decision on whether or not to use it’s services.

Originally posted 2017-02-22 14:19:20.

Tags: Health by rogerComments Off on Improving Oral Health For Patients With Alzheimer’s Disease Or Related Disorders (ADRD)

This article appears on the Reuters news service (similar articles on the topic are available from a number of other media source)

WASHINGTON (Reuters) – A study in mice suggests using cellphones may help prevent some of the brain-wasting effects of Alzheimer’s disease, U.S. researchers said on Wednesday.

After long-term exposure to electromagnetic waves such as those used in cell phones, mice genetically altered to develop Alzheimer’s performed as well on memory and thinking skill tests as healthy mice, the researchers wrote in the Journal of Alzheimer’s Disease.

The results were a major surprise and open the possibility of developing a noninvasive, drug-free treatment for Alzheimer’s, said lead author Gary Arendash of the University of South Florida.

He said he had expected cell phone exposure to increase the effects of dementia.

“Quite to the contrary, those mice were protected if the cell phone exposure was stared in early adulthood. Or if the cellphone exposure was started after they were already memory- impaired, it reversed that impairment,” Arendash said in a telephone interview.

Arendash’s team exposed the mice to electromagnetic waves equivalent to those emitted by a cellphone pressed against a human head for two hours daily over seven to nine months.

At the end of that time, they found cellphone exposure erased a build-up of beta amyloid, a protein that serves as a hallmark of Alzheimer’s disease.

The Alzheimer’s mice showed improvement and had reversal of their brain pathology, he said.

“It (the electromagnetic wave) prevents the aggregation of that bad protein of the brain,” Arendash said. “The findings are intriguing to us because they open up a whole new field in neuroscience, we believe, which is the long-term effects of electromagnetic fields on memory.”

Arendash said his team was modifying the experiment to see if they could produce faster results and begin testing humans.

Despite decades of research, there are few effective treatments and no cure for Alzheimer’s, the most common form of dementia. Many treatments that have shown promise in mice have had little effect on humans.

More than 35 million people globally will suffer from Alzheimer’s disease or other forms of dementia in 2010, according to the Alzheimer’s Association.

There has been recent controversy about whether electromagnetic waves from cellphones cause brain cancer.

Co-author Chuanhai Cao said the mice study is more evidence that long-term cellphone use is not harmful to the brain.

Groups such as the World Health Organization, the American Cancer Society, and the National Institutes of Health, have all concluded that scientific evidence to date does not support any adverse health effects associated with the use of cellphones.

I will point out that this is a just study (done on mice), and you need to consider that there may be effects from cell phones that aren’t beneficial. In addition, one would have to conclude that if you use a headset the radiation effect from the cell phone on your brain would be greatly diminished.

This is not the first time Gary Arendash has had theories on Alzheimer’s published by the news media.

The following is an except from a Denver Post opinion article by Rhonda Hackett (a clinical psychologist born in Canada, living in the US)

Myth: Taxes in Canada are extremely high, mostly because of national health care.

In actuality, taxes are nearly equal on both sides of the border. Overall, Canada’s taxes are slightly higher than those in the U.S. However, Canadians are afforded many benefits for their tax dollars, even beyond health care (e.g., tax credits, family allowance, cheaper higher education), so the end result is a wash. At the end of the day, the average after-tax income of Canadian workers is equal to about 82 percent of their gross pay. In the U.S., that average is 81.9 percent.

Myth: Canada’s health care system is a cumbersome bureaucracy.

The U.S. has the most bureaucratic health care system in the world. More than 31 percent of every dollar spent on health care in the U.S. goes to paperwork, overhead, CEO salaries, profits, etc. The provincial single-payer system in Canada operates with just a 1 percent overhead. Think about it. It is not necessary to spend a huge amount of money to decide who gets care and who doesn’t when everybody is covered.

Myth: The Canadian system is significantly more expensive than that of the U.S.Ten percent of Canada’s GDP is spent on health care for 100 percent of the population. The U.S. spends 17 percent of its GDP but 15 percent of its population has no coverage whatsoever and millions of others have inadequate coverage. In essence, the U.S. system is considerably more expensive than Canada’s. Part of the reason for this is uninsured and underinsured people in the U.S. still get sick and eventually seek care. People who cannot afford care wait until advanced stages of an illness to see a doctor and then do so through emergency rooms, which cost considerably more than primary care services.

What the American taxpayer may not realize is that such care costs about $45 billion per year, and someone has to pay it. This is why insurance premiums increase every year for insured patients while co-pays and deductibles also rise rapidly.

Myth: Canada’s government decides who gets health care and when they get it.While HMOs and other private medical insurers in the U.S. do indeed make such decisions, the only people in Canada to do so are physicians. In Canada, the government has absolutely no say in who gets care or how they get it. Medical decisions are left entirely up to doctors, as they should be.

There are no requirements for pre-authorization whatsoever. If your family doctor says you need an MRI, you get one. In the U.S., if an insurance administrator says you are not getting an MRI, you don’t get one no matter what your doctor thinks — unless, of course, you have the money to cover the cost.

Myth: There are long waits for care, which compromise access to care.There are no waits for urgent or primary care in Canada. There are reasonable waits for most specialists’ care, and much longer waits for elective surgery. Yes, there are those instances where a patient can wait up to a month for radiation therapy for breast cancer or prostate cancer, for example. However, the wait has nothing to do with money per se, but everything to do with the lack of radiation therapists. Despite such waits, however, it is noteworthy that Canada boasts lower incident and mortality rates than the U.S. for all cancers combined, according to the U.S. Cancer Statistics Working Group and the Canadian Cancer Society. Moreover, fewer Canadians (11.3 percent) than Americans (14.4 percent) admit unmet health care needs.

Myth: Canadians are paying out of pocket to come to the U.S. for medical care.Most patients who come from Canada to the U.S. for health care are those whose costs are covered by the Canadian governments. If a Canadian goes outside of the country to get services that are deemed medically necessary, not experimental, and are not available at home for whatever reason (e.g., shortage or absence of high tech medical equipment; a longer wait for service than is medically prudent; or lack of physician expertise), the provincial government where you live fully funds your care. Those patients who do come to the U.S. for care and pay out of pocket are those who perceive their care to be more urgent than it likely is.

Myth: Canada is a socialized health care system in which the government runs hospitals and where doctors work for the government.Princeton University health economist Uwe Reinhardt says single-payer systems are not “socialized medicine” but “social insurance” systems because doctors work in the private sector while their pay comes from a public source. Most physicians in Canada are self-employed. They are not employees of the government nor are they accountable to the government. Doctors are accountable to their patients only. More than 90 percent of physicians in Canada are paid on a fee-for-service basis. Claims are submitted to a single provincial health care plan for reimbursement, whereas in the U.S., claims are submitted to a multitude of insurance providers. Moreover, Canadian hospitals are controlled by private boards and/or regional health authorities rather than being part of or run by the government.

Myth: There aren’t enough doctors in Canada.

From a purely statistical standpoint, there are enough physicians in Canada to meet the health care needs of its people. But most doctors practice in large urban areas, leaving rural areas with bona fide shortages. This situation is no different than that being experienced in the U.S. Simply training and employing more doctors is not likely to have any significant impact on this specific problem. Whatever issues there are with having an adequate number of doctors in any one geographical area, they have nothing to do with the single-payer system.

Have you noticed all the advertisements attempting to stop heath care reform in this country?

Mainly the ads seem to be targeted at preventing the reconciliation of the Senate and House plans to include a public option.

If you look into who’s funding these advertisements you probably won’t be surprised that it’s the health care industry looking after their interests (which aren’t your interests unless you’re a major stock holder in one or more of the insurance companies or health care companies in this country).

Patients First is a project of Americans for Prosperity, an organization run by Art Pope (aka “The Knight of the Right”). Heavily funded by corporate American — heavily funded by the health care industry.

There’s simply nothing grass roots about them — and they do not represent the interests of the average American. They represent special interests, the extreme right, and the health care industry itself.

Obviously the American health care industry is spending money because they don’t want their lucrative business model changed.

Personally I question any organization’s motives when they attempt to hide where their funding comes from.

Dig deeper, you might not like what you find — and don’t just listen to the rhetoric, learn what’s at stake.

This is from an article on by Sarah Varney (KQED – San Francisco, CA, US – Public Media for Northern California) re-published on NPR.

Amid the debate about reforming heath care in the United States, it’s tough to turn on your television these days without hearing a political ad condemning the Canadian health care system.

One such ad from Americans for Prosperity features a woman talking of her experience with getting treatment for cancer.

“I survived a brain tumor, but if I’d relied on my government for health care, I’d be dead. I am a Canadian citizen. As my brain tumor got worse, my government health care system told me I had to wait six month to see a specialist,” the woman says.

The ads are provocative, but just how accurately do they portray Canada’s system?

At a small doctor’s office in the gritty working-class neighborhood of East Vancouver, Dr. Larry Barzelai meets with John and Bessie Riley, who have been his patients for more than 20 years.

John Riley was recently diagnosed with colon cancer. Contrary to the woman in the TV ad, he says his experience getting in to see specialists has been “nothing but good” so far. “Everything’s gone bang, bang. I’ve had no waiting times for anything,” he says, adding that his only out-of-pocket expense has been the cost of getting to the doctor’s office.

Socialized Insurance, Not Socialized Medicine

Canada has a universal health care system that’s paid for through income taxes and sales tax. All Canadians are covered, and they can see any doctor they want anywhere in the country with no copays or deductibles. Some things aren’t covered: optometry, dentistry and outpatient prescription drugs. Many Canadians have private insurance to cover those services, though some struggle to pay for them out of pocket.

U.S. critics of Canadian health care like to call it socialized medicine, but it’s more like socialized insurance — meaning the risk is pooled together. And while the individual provinces and territories set their overall health budgets and administer the health plans, the delivery of medical care is private. Doctors run their own businesses and then bill the government.

Barzelai says physicians in Canada earn a good living and aren’t faced with the same administrative hassles that American doctors gripe about. “Medical costs here are half of what medical costs in the States are,” he says. “At the same time, our infant mortality is lower, our life expectancy is longer, our rates of obesity are a lot less. So there’s got to be some positive aspects of living in Canada and with the Canadian medical system.”

The Commonwealth Fund, a respected and nonpartisan U.S. health research organization, looked at deaths that could have been prevented with access to quality medical care in the leading 19 industrialized countries. In the latest survey, the United States ranked last and Canada came in sixth.

Professor Bob Evans, one of the grandfathers of the health economics field, has been studying the Canadian and U.S. systems since they were founded around the same time in the mid-1960s. He says that what many Americans hear about Canada — rationed care, long wait lists and a government bureaucrat who gets in between a patient and doctor — is “absolute nonsense.”

“Are there cases of people who wind up not getting the care they need at appropriate times? Yes, of course there are,” says Evans, who is with the Centre for Health Policy Research at the University of British Columbia in Vancouver. “This is a huge system and it’s a very complicated one and things do go wrong. But as a general rule, what happens here is that when you need the care, you get it.” But that wasn’t always the case.

‘The Most Frustrating Moments In Our System’

When federal spending on Canadian health care declined during a recession in the 1990s, lines for non-urgent procedures — and some urgent ones — grew. A few years later, Canada’s Supreme Court found that some patients had in fact died as a result of waiting for medical services. Stories of the deaths and of residents traveling to the U.S. for medical care dominated Canadian news coverage.

In response, Canada’s government poured billions of dollars into reducing wait times in the five medical areas deemed most troublesome, including cancer care, cardiac care and joint replacement surgery. And wait times for these services has dropped: Most provinces now report those times on publicly available Web sites. Such data — and public accountability — don’t exist in the U.S.

But that’s not to say there still aren’t frustrations with waiting for medical care in Canada.

Jocelyn Thompkinson is a peppy 29-year-old who was born with a neural tube defect similar to spina bifida. “I haven’t been able to walk since I was 8, and I’ve had lots of surgeries, lots of medical interventions of various types,” she says at BC Children’s Hospital, in a leafy Vancouver neighborhood. “But beyond that, I hold a job, I have a pretty much normal life.”

She credits an army of Canadian doctors and physical therapists for giving her that normal life, though there have been roadblocks. “Of course there were some times when I had to wait for care, and those are always the most frustrating moments in our system,” Thompkinson says. Several years ago, when she was on a long waiting list for a pain clinic in Vancouver, she traveled to Seattle and then Texas to get care. The visits and tests cost her $1,800.

Few Canadians actually go south for medical care, though. Canadian researchers say it’s a bit like getting struck by lighting — it’s extremely rare, but when it happens, everyone talks about it.

Provincial governments do pay for Canadians to receive specialty care in the U.S. in some cases. For example, a shortage of neonatal beds means a small number of women with high-risk pregnancies are sent to U.S. hospitals to deliver their babies.

It doesn’t happen often, though, and public opinion polls continue to show strong support for publicly financed, universal health care in Canada.